新冠肺炎大流行对按性别、年龄和心理健康状况分层的身体残疾患者家庭护理使用的影响：使用管理健康数据的队列研究

摘要(中文译文)

这项研究调查了新冠肺炎大流行对身体残疾者家庭护理服务使用的影响，按年龄、性别和心理健康状况进行了分层。使用加拿大安大略省ICES的链接卫生行政数据库，在两个时期评估了个人支持和护理服务的月度利用率：疫情前（2015年3月至2020年2月）和疫情期间（2020年3月到2022年6月）。预测自回归综合移动平均（ARIMA）模型用于估计服务使用的变化。在疫情期间，多个子群体的个人支持服务使用率显著下降，其中一些群体受到的影响更大。在78.5%的月份，男性、14.3%的女性和78.5%的65岁个体出现了显著下降 65岁及以下人群占17.9% 对于有心理健康问题的人，这一比例为78.5%。相比之下，护理服务的使用显著增加，男性有85.7%的月份、女性有60.7%的月份、65岁的月份有60.7%有显著增加 65岁及以下人群占17.9% 年，有心理健康问题的人为85.7%，没有心理健康问题者为28.6%。这些发现突显了疫情对不同亚群的影响存在很大差异，某些群体受到的影响不成比例。需要有针对性的战略来缓解这些差距，并确保公平获得家庭护理服务。需要进一步的研究来探索这些差异的长期影响和潜在因素。

Abstract

This study investigated the impact of the COVID-19 pandemic on homecare service use among individuals with physical disabilities, stratified by age, sex, and mental health conditions. Monthly utilization of personal support and nursing services was assessed using linked health administrative databases from ICES in Ontario, Canada, over two periods: pre-pandemic (March 2015 to February 2020) and during the pandemic (March 2020 to June 2022). Predictive Autoregressive Integrated Moving Average (ARIMA) models were used to estimate changes in service use. During the pandemic, personal support service use declined significantly across multiple subgroups with some groups experiencing greater impacts. Significant decreases were observed in 78.5% of months for males, 14.3% for females, 78.5% for individuals aged 65 years and younger, 17.9% for those older than 65 years, and 78.5% for individuals with mental health conditions. In contrast, nursing service use increased significantly, with significant increases observed in 85.7% of months for males, 60.7% for females, 60.7% for those aged 65 years and younger, 17.9% for those older than 65 years, 85.7% for individuals with mental health conditions, and 28.6% for those without mental health conditions. The findings highlight substantial variation in the pandemic's impact across subpopulations, with certain groups disproportionately affected. Targeted strategies are needed to mitigate these disparities and ensure equitable access to homecare services. Further research is warranted to explore the long-term implications and the underlying factors contributing to these differences.

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